Individual
MARIAH M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1215 W LEWIS ST, PASCO, WA 99301-5472
(509) 543-6700
Mailing address
4343 KING DR, WEST RICHLAND, WA 99353-9388
(541) 974-3349
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61087668
WA
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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